Transcript positive psychology and goal-achieving psychotherapy (gap)

POSITIVE PSYCHOLOGY
AND GOAL-ACHIEVING
PSYCHOTHERAPY (GAP)
Ronald S. Kaiser, Ph.D., ABPP
Licensed Psychologist
Clinical Associate Professor, Department of Neurology,
Thomas Jefferson University
Jefferson Headache Center
POSITIVE PSYCHOLOGY DEFINED
• Positive psychology is that branch of psychology that
involves the study and promotion of well-being.
• The gold standard for measuring well-being is
flourishing.
• The goal of positive psychology is the increase of
flourishing.
Seligman, 2011
POSITIVE PSYCHOLOGY DEFINED (2)
• Psychology is not just the study of pathology, weakness,
and damage. It is also the study of strength and virtue.
• Treatment is not just fixing what is broken. It is nurturing
what is best.
Seligman & Csikszentmihalyi (2000)
Positive Psychology can be incorporated into other approaches to treatment.
WHAT DETERMINES HAPPINESS?
Lyubomirsky, 2007
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PSYCHOTHERAPY COMES FROM A
DISEASE REDUCTION MODEL
• Historical definition of health = Absence of disease.
• Psychoanalytic goal of tension-reduction.
• CBT focuses on irrational beliefs, automatic negative
thoughts, etc.
• DSM gold standard is “No Diagnosis”.
• Reportable scales on the MMPI are the elevated ones.
• NIMH funding is granted for disease research.
WHO DEFINITIONS OF HEALTH AND
MENTAL HEALTH HAVE CHANGED
• Health is a state of complete physical, mental and social
well-being, and not merely the absence of disease or
infirmity.
• Mental Health is a state of well-being in which an
individual realizes his or her own abilities, can cope with
the normal stresses of life, can work productively, and is
able to make a contribution to his or her community.
PSYCHOLGY’S CONTRIBUTIONS TO
LEARNING HAVE IMPACTED ON
• Schools
• Parenting
• Sports
• Industry
But not necessarily on the conduct of psychotherapy
PSYCHOLOGY AND INDUSTRY
• Often co-opted by other disciplines
• Effectiveness trumps credentials
• Laid the groundwork for the coaching profession
• Are you familiar with?
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Seth Godin
Brian Tracey
Jim Rohm
Stephen Hovey
Napoleon Hill
Tony Robbins
MORE MOTIVATING THAN MONEY
(AFTER A CERTAIN POINT)
• Autonomy
• Mastery
• Purpose
LET’S START WITH A BIT OF SELFDISCLOSURE
• The influence of Jim Murray
• The influence of Don Meredith
• The influence of Dr. Benjamin Shimberg
• The influence of the gym
• The role of context
• The arrival of positive psychology
• The internet
SOME NEW DEVELOPMENTS THAT
AFFECT THEORY BUILDING
• Brain Plasticity
• Mindfulness
• The role of physical exercise
• The role of mental exercise
• Health Psychology
• Biofeedback/Neurofeedback
• The early work in positive psychology
• The internet
THE SPECIAL ROLE OF BRAIN
PLASTICITY
• The historical belief was that after childhood the brain
could only change in one direction – Decline.
• Hardwiring: the concept that the brain was more like a
computer than a muscle.
• Research has dramatically changed this thinking
RESEARCH ON THE CHANGING
BRAIN
• Taub’s Constraint Induced (CI) Movement Therapy.
• Competitive plasticity and Merzenich’s brain mapping.
• The role of mental rehearsal (Pascal-Leone’s piano
students; Sharansky’s imprisonment).
• Maguire’s research on the posterior hippocampuses of
London taxi drivers (Maguire, Current Biology, 2011).
• Mirror neurons (Iacoboni, 2009)
THE ROLE OF PHYSICAL EXERCISE
• What did Freud, Rogers, Skinner, Ellis, etc. have to say about
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exercise?
What have Seligman, Achor, and other positive psychologists
said about exercise?
MacArthur Foundation studies demonstrate 3 ways of reducing
cognitive decline (normal weight, lifelong learning, exercise)
Studies demonstrate that if you are middle-age and sedentary
and you start a regular exercise program, you can delay the
onset of cognitive decline by 10-15 years (Ratey; Kramer).
Naperville, IL, 8th graders finished #1 in the world in science &
6th in math after being involved in a comprehensive daily PE
program.
THE BRAIN AND POSITIVE
PSYCHOLOGY
POSITIVE PSYCHOLOGY EMERGES
IN AN AGE OF SCIENCE
• Commitment to research
• Criticisms of humanistic psychology for insufficient
research base.
• Unlike Freud, Rogers, Ellis, Positive Psychology was
largely developed by academics rather than clinicians
THE SEMINAL ARTICLE
• Seligman, M., & Csikszentmihalyi, M. (2000). Positive
psychology: An introduction. American Psychologist, 55
(1), 5-14.
PIONEERS OF THE POSITIVE
PSYCHOLOGY MOVEMENT
• Ed Diener (“Dr Happiness; Subjective well-being)
• George Vaillant (longitudinal study of successful aging)
• MIHALYI CSIKSZENTMIHALYI
• MARTIN SELIGMAN
• Barbara Fredrickson (Broaden and Build; Positivity Ratio)
• Christopher Peterson* (Values in Action project)
THE NEXT GENERATION OF LEADERS
IN POSITIVE PSYCHOLOGY
• Sonja Lyubomirsky (Happiness)
• Todd Kashian (Curiosity)
• Karen Reivich (Resilience)
• Angela Duckworth (Grit)
• Robert Vallarand (Passion)
• Tal Ben-Shahar (General student body teaching)
• Shawn Achor (Consulting)
THE CONTRIBUTIONS OF CAROL
DWECK
• Mindset: The view that you adopt for yourself.
• Fixed Mindset: The belief that your qualities are
unchangeable – and you have to keep proving yourself over
and over.
Related to being praised for your attributes.
• Growth Mindset: The belief that your basic qualities can be
changed by your efforts.
Related to being praised for your efforts.
• Substantial research supports the benefits of the growth
mindset.
CSIKSZENTMIHALY
• As World War II approached in Europe, he observed how
some adults became helpless as social supports decayed
while others maintained their integrity.
• His work in the U.S. led to his development of the concept
of Flow and its role in the development of Positive
Psychology.
FLOW
• The optimal experience.
• It does not “just happen” passively, but you can’t force yourself into
flow.
• It involves being fully focused, motivated, energized, and involved in
an activity.
• You can’t be depressed or anxious and able to be in a state of flow.
• Contrary to popular belief, life’s best moments are when we are
stretched to physical and/or mental limits rather than relaxed.
• Our best moments may not necessarily be pleasant at the time.
• Experiences that result in flow for us are not universal.
THE CONDITIONS OF FLOW
• Goals are clear
• Feedback is immediate
• There is a balance between opportunity and capacity
• Concentration is deep
• The sense of time is altered
TRAITS OF THE AUTOTELIC
PERSONALITY
• Curiosity
• Persistence
• Low self-centeredness
• Oriented toward performing activities for intrinsic reasons
only.
SELIGMAN
• His journey went from Learned Helplessness to Learned
Optimism to Authentic Happiness to Flourish - and the
psychology of well-being.
• Developed the MAPP program at Penn.
• Instrumental in developing major positive psychology
concepts – including Signature Strengths and PERMA.
• Collaborated with Chris Peterson in researching and
writing Character Strengths and Virtues.
PERMA
• Positive Emotion
• Engagement
• Relationships
• Meaning
• Accomplishment
CHARACTER STRENGTHS AND
VIRTUES
• Positive Psychology’s answer to the DSM and ICD – “A
Manual for the Sanities”.
• The focus is on what is right about people rather than
what is wrong.
• Based on substantial research across cultures.
• 6 Virtues encompass 24 Character Strengths.
STRENGTHS OF WISDOM AND
KNOWLEDGE
• Creativity (Originality, Ingenuity)
• Curiosity (Interest, Novelty-seeking, Openness to
Experience)
• Open-mindedness (Judgment, Critical Thinking)
• Love of Learning
• Perspective (Wisdom)
STRENGTHS OF HUMANITY
• Love
• Kindness (Generosity, Nurturance, Care Compassion,
Altruistic Love, “Niceness)
• Social Intelligence (Emotional Intelligence, Personal
Intelligence)
STRENGTHS OF JUSTICE
• Citizenship (Social Responsibility, Loyalty, Teamwork)
• Fairness
• Leadership
STRENGTHS OF TEMPERANCE
• Forgiveness and Mercy
• Humility and Modesty
• Prudence
• Self-Regulation (Self-Control)
STRENGTHS OF TRANSCENDENCE
• Appreciation of Beauty and Excellence (Awe, Wonder,
Elevation)
• Gratitude
• Hope (Optimism, Future-Mindedness, Future Orientation)
• Humor (Playfulness)
• Spirituality (Religiousness, Faith, Purpose)
STRENGTHS OF COURAGE
• Bravery
• Persistence (Perseverance, Industriousness)
• Integrity (Authenticity, Honesty)
• Vitality (Zest, Enthusiasm, Vigor, Energy)
ASSESSING SIGNATURE STRENGTHS
• Go to www.authentichappiness.org
• VIA Survey of Character strengths (240 items)
• Brief Strengths Test (24 items)
• Several other tests
• Test results are used for research as well as your own
benefit/
OTHER INDICATORS OF STRENGTHS
• Resilience
• Savoring
• Grit
• Posttraumatic Growth
FREDRICKSON’S 10 TOP POSITIVE
EMOTIONS
• Joy
• Pride
• Gratitude
• Amusement
• Serenity
• Inspiration
• Interest
• Awe
• Hope
• Love
MEASURES OF POSITIVE
INTERACTIONS
• The Losada Line and Ratio
• The Fredrickson Positivity Ratio
RESEARCH SUPPORTIVE OF
POSITIVE PSYCHOLOGY CONCEPTS
• Education
• Health
• Aging
• Work-related
• The Military
POSITIVE PSYCHOLOGY AND HEALTH
• Positive psychological well-being is associated with:
Fewer colds
Reduced mortality in both healthy & ill populations
Reduced cardio-vascular disease
Reduced mortality from CVD , renal failure, & HIV
• Findings with respect to cancer are more equivocal
• No study has demonstrated a relationship between
pessimism and better health or reduced mortality.
THE IMPORTANCE OF THE SOCIAL
NETWORK
• Strength of social relationships is the major distinguishing
characteristic of the happiest 10 % of the population.
(Diener & Seligman, 2002)
• There are “70 years of evidence that our relationships
with others matter, and matter more than anything else in
the world.
(Vaillant, 2009)
• The concepts of social capital and reciprocity
THE IMPORTANCE OF A SOCIAL
NETWORK
You should always go to other people’s
funerals; otherwise they won’t come to
yours.
Yogi Berra
POSITIVE PSYCHOLOGY EXERCISES
• The What-Went-Well (or 3 Good Things or 3 Blessings)
Exercise
• The Gratitude Visit
• The 21 day rule for positive behavior change
• The 20 second rule
• The Reverse 20 second rule
• The Modified Presidential Campaign Assessment
SELIGMAN’S ABCD EXERCISE
• Adversity
• Belief
• Consequences
• Disputation
• Energization
CRITICISMS OF POSITIVE
PSYCHOLOGY
• The scientists and philosophers
• The generalizers and over-simplifiers
• The anti-military
• Barbara Ehrenreich
INTERNATIONAL POSITIVE
PSYCHOLOGY ASSOCIATION
For information or to join
www.ippanetwork.org
3rd Annual World Congress was held in Los Angeles on
June 23-27, 2013
GOAL-ACHIEVING PSYCHOTHERAPY:
A MODEL FOR POSITIVE PRACTICE
• GAP builds upon the research orientation and philosophy
of positive psychology.
• GAP builds upon effective techniques of practice from
several approaches, primarily CBT.
• GAP introduces unique concepts involving the role of the
therapist, the purpose of psychotherapy, history, the goals
of treatment, and the process.
GOAL-ACHIEVING PSYCHOTHERAPY
(GAP)
• Bridges the GAPs between:
Thinking and doing
Gaining and maintaining
The past and the future
Science and practice
PRINCIPLES AND PRACTICES OF GAP
(1)
• The approach is forward looking and positive.
• The approach is geared toward building personal strengths to
manage change and growth.
• The focus is primarily on the solution, not the problem.
• The past is meaningful – especially as it relates to character
strengths and achievements.
• The therapist is active, directive, supportive and a cheerleader
for growth and change.
PRINCIPLES AND PRACTICES OF GAP
(2)
• The patient/client is active in preparing a Mission Statement and
setting an achieving goals.
• Goal setting is designed to ensure maximum success by utilizing
small and measureable forward steps.
• Wallowing is avoided.
• Activity is the default.
• Once positive commitment and direction is implemented, other forms
of therapy can be incorporated.
• Positive personality change can take place throughout the life span.
PRINCIPLES AND PRACTICES OF GAP
(3)
• The Type P Personality is the model of the healthy personality.
• Emotional health is always a work in progress.
• GAP principles can be pursued on a do-it-yourself basis, in
therapy, or through coaching – depending upon your needs at
any specific time.
• GAP-specific materials are available to aid in the
implementation and maintenance of progress.
• www.thementalhealthgym.com is the ongoing source of GAP
resources and information.
THE GYM AS A MODEL
• Wellness is a central concept
• Open to all shapes and sizes
• Individual measureable goals
• Diagnosis is descriptive, not prescriptive.
GAP ASSESSMENT ALTERNATIVES TO
TRADITIONAL DIAGNOSIS
• Competent Person’s Disease – “the addiction to 2nd place”
• The “Too Excuse”
• Over-thinking
• Under-rating (A/Fail thinking: Ascribing unimportance to
achievements; Luck)
• Waiting for an A
THE TYPE P PERSONALITY
• The ultimate goal
• Assessment is done throughout the process
• Roughly comparable to PERMA
TYPE P PERSONALITY
• Personal goal-directed
• Proactive
• Positive
• Persistent
• Playful
THE INTRODUCTORY SESSION
• Understanding the reason for treatment
• Expression of therapist gratitude as part of informed
consent
• Explanation of process and philosophy
• History-taking within the context of strength-building
• Introduction to the role of activity level and homework
THE ROLE OF HISTORY
• Establish early the importance of moving forward to
develop strengths.
• Identify unhappy aspects of history – to primarily use in
the future.
• Identify positive aspects of history.
“When was the best time in your life?”
“What things do you like most about yourself?”
“What makes you so resilient?”
Be prepared to revisit history from a position of strength.
GETTING UNSTUCK: THE CRITICAL
QUESTIONS
1. Are you a fortune teller?
2. What can go right?
3. What does this have to do with you?
4. How is this getting you where you want to go?
5. What will you do now to maintain your success?
THE TECHNIQUES OF GAP (1)
Vision without execution is hallucination.
Thomas Edison
THE TECHNIQUES OF GAP (2)
• The Mission Statement
• The current goals
Benefits
Impediments
Strengths to overcome impediments
• Areas for change and growth
Health and fitness
Cognitive functioning
Social
THE TECHNIQUES OF GAP (3)
• Exercise Cards
• Create Your Proactive Positive Explosion Form
• Type P Personality Development Form
• DEFAULTS ARE ACTIVE
THERAPEUTIC CONSIDERATIONS
• The therapist as a role model
• Phone calls
• No shows
• Suicidal ideation or threats
• Patient sabotage
• Session intensity
HOW DO YOU KNOW WHEN YOU ARE
DONE?
• Does the person conform to the mission statement?
• How well does s/he meet the criteria for Type P
Personality?
• Has the personal tipping point (Proactive Positive
Explosion) been achieved?
• Has a maintenance program been put in place?
• Are conditions right for continued flourishing?
SUCCESSFUL APPLICATIONS OF GAP
TO SPECIAL POPULATIONS
• Some Axis II populations
• Habit control
• Depression
• PTSD
• Headache patients
WHY DOESN’T IT WORK FOR
EVERYONE?
• Nothing does.
• Expectancy of therapy as a place to wallow may not be
met.
• Using the gym as a model, it is notable that people who
drop out may successfully return in the future.
• Intensity and/or homework turn some people off.
• It’s still a work in progress without a lot of external input.
THE CHALLENGE
• The incidence of depression has risen every year since
the early 20th century.
• Depression is the leading cause of disability in the U.S.
for individuals between the ages of 15-44.
• The average age of initial diagnosis is getting younger.
• Depression is the most costly disease in he world
although up to half of the cases that meet the criteria for
depression at any one time go untreated.
IT IS HARD TO BE POSITIVE AND DEPRESSED AT THE
SAME TIME.
THANK YOU!
•
• Your comments are important to me.
Please feel free to contact me at
[email protected]
215-955-2743
Or
[email protected]
215-704-0983